Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

April 24, 2018; 90 (17) Article

Neurocognition, sleep, and PET findings in type 2 vs type 1 narcolepsy

Yu-Shu Huang, Ing-Tsung Hsiao, Feng-Yuan Liu, Fang-Ming Hwang, Kuang-Lin Lin, Wen-Cheng Huang, Christian Guilleminault
First published March 30, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005346
Yu-Shu Huang
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ing-Tsung Hsiao
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Feng-Yuan Liu
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fang-Ming Hwang
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kuang-Lin Lin
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wen-Cheng Huang
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christian Guilleminault
From the Department of Child Psychiatry, Sleep Center and Craniofacial Research Center (Y.-S.H.), Department of Nuclear Medicine and Molecular Imaging Center (I.-T.H., F.-Y.L., W.-C.H.), and Division of Pediatric Neurology (K.-L.L.), Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Medical Imaging and Radiological Sciences, College of Medicine (I.-T.H., F.-Y.L.), Chang Gung University, Taoyuan; Department of Education (F.-M.H.), National Chia-Yi University, Chiayi, Taiwan; and Stanford University Sleep Medicine Division (C.G.), Redwood City, CA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Neurocognition, sleep, and PET findings in type 2 vs type 1 narcolepsy
Yu-Shu Huang, Ing-Tsung Hsiao, Feng-Yuan Liu, Fang-Ming Hwang, Kuang-Lin Lin, Wen-Cheng Huang, Christian Guilleminault
Neurology Apr 2018, 90 (17) e1478-e1487; DOI: 10.1212/WNL.0000000000005346

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
158

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective To analyze differences in functional brain images collected in patients with type 2 and type 1 narcolepsy compared to normal controls and the relationship among brain images, objective neuropsychologic tests, and sleep findings.

Methods Data collection included comprehensive clinical investigation, study of sleep/wake with actigraphy, polysomnography, Multiple Sleep Latency Test, human leukocyte antigen typing, 18F-fluorodeoxyglucose PET, and cognitive tests obtained from 29 patients with type 2 narcolepsy, 104 patients with type 1 narcolepsy, and 26 sex- and age-matched normal control individuals. Conners’ Continuous Performance Test (CPT II) and Wisconsin Card-Sorting Task were performed simultaneously with the FDG-PET examination. After analyses of variance, data between patients with type 1 and type 2 narcolepsy were compared by post hoc analysis, and correlation between functional brain imaging findings and results of neurocognitive tests was obtained.

Results All patients with narcolepsy presented with at least 2 sleep-onset REM periods (SOREMP) and subjective sleepiness. Patients with type 2 narcolepsy compared to patients with type 1 narcolepsy had significantly less SOREMP, longer mean sleep latencies, and lower body mass indexes, apnea-hypopnea indexes, and frequency of human leukocyte antigen DQ-Beta1*0602. In patients with type 2 narcolepsy, FDG-PET studies showed significantly less hypermetabolism in the fusiform gyrus, striatum, hippocampus, thalamus, basal ganglia, and cerebellum than in patients with type 1 narcolepsy, and significantly less hypometabolism in the regions of frontal lobe, posterior cingulum, angular gyrus, and part of the parietal lobe; these changes were associated with fewer errors on the CPT.

Conclusion Young patients with type 2 narcolepsy have fewer clinical impairments and less distinct brain functional abnormalities than patients with type 1 narcolepsy, who are significantly more affected.

Glossary

ANOVA=
analysis of variance;
CPT II=
Conners' Continuous Performance Test;
DLPFC=
dorsolateral prefrontal cortex;
DMN=
default mode network;
ESS=
Epworth Sleepiness Scale;
FDG=
18F-fluorodeoxyglucose;
HLA=
human leukocyte antigen;
ICSD-3=
International Classification of Sleep Disorders–3;
MSLT=
Multiple Sleep Latency Test;
OSA=
obstructive sleep apnea;
PDSS=
Pediatric Daytime Sleepiness Scale;
PSG=
polysomnography;
RT=
reaction time;
SOREMP=
sleep-onset REM periods;
SUVR=
standard uptake value ratio;
TPN=
task-positive network;
WCST=
Wisconsin Card-Sorting Test

Footnotes

  • ↵* These authors contributed equally to this work.

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Patient Page: NPub.org/patient

  • Received December 3, 2016.
  • Accepted in final form January 4, 2018.
  • © 2018 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • Glossary
    • Methods
    • Results
    • Discussion
    • Author contributions
    • Study funding
    • Disclosure
    • Acknowledgment
    • Footnotes
    • References
  • Figures & Data
  • Info & Disclosures
Advertisement

Effect of Atogepant for Preventive Migraine Treatment on Patient-Reported Outcomes in the Randomized, Double-blind, Phase 3 ADVANCE Trial

Dr. Jessica Ailani and Dr. Ailna Masters-Israilov

► Watch

Topics Discussed

  • Narcolepsy
  • Other hypersomnias
  • PET
  • Neuropsychological assessment

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    Validation of Multiple Sleep Latency Test for the diagnosis of pediatric narcolepsy type 1
    Fabio Pizza, Lucie Barateau, Isabelle Jaussent et al.
    Neurology, August 12, 2019
  • Editorial
    Better biomarkers for childhood narcolepsy-cataplexy
    Are we there?
    Sanjeev V. Kothare, Suresh Kotagal et al.
    Neurology, August 12, 2019
  • Articles
    Diagnostic aspects of narcolepsy
    Michael S. Aldrich et al.
    Neurology, February 01, 1998
  • Articles
    Effect of age on MSLT results in patients with narcolepsy–cataplexy
    Y. Dauvilliers, A. Gosselin, J. Paquet et al.
    Neurology, January 12, 2004
Neurology: 100 (23)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise